DR. KELLY KISTLER (NPI# 1780908582) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780908582 |
| Entity Type | Individual |
| Full Name | DR. KELLY KISTLER |
| Credential | PHARM.D. |
| Practice Address |
23620 N 20th Dr Suite 12 Phoenix AZ 85085-0621 |
| Mailing Address |
20710 N 51st Dr Glendale AZ 85308-9369 |
| Practice Telephone | 6027901802 |
| Mailing Telephone | 6027901802 |
| Enumeration Date | 2010-03-23 |
| Last Update Date | 2010-03-23 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | S017269 | AZ | Pharmacy Service Providers |
| Street Address |
23620 N 20TH DR SUITE 12 |
| City | PHOENIX |
| State | AZ |
| Zip Code | 85085-0621 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891732145 | Praxair Healthcare Services, Inc. | Durable Medical Equipment & Medical Supplies | 23620 N 20th Dr, Suite 10, Phoenix, AZ 85085-0621 | 2006-06-02 |
| 1669920385 | Jenna Vaughn | Pharmacist | 23620 N 20th Dr, Suite 12, Phoenix, AZ 85085-0621 | 2016-09-12 |
| 1508230376 | Joseph A. Mauro | Pharmacist | 23620 N 20th Dr, Suite 12, Phoenix, AZ 85085-0621 | 2015-11-17 |
| 1730481706 | Jeffrey K Karp | Pharmacist | 23620 N 20th Dr, Ste 12, Phoenix, AZ 85085-0621 | 2010-11-24 |
| 1407182751 | Kerry Colleen Conway | Pharmacist | 23620 N 20th Dr, #12, Phoenix, AZ 85085-0621 | 2009-10-21 |
| 1487793121 | The Apothecary Shop Wholesale Inc | Pharmacy | 23620 N 20th Dr, Ste 12, Phoenix, AZ 85085-0621 | 2007-02-06 |
| 1649317579 | Optum Pharmacy 801, Inc. | Durable Medical Equipment & Medical Supplies | 23620 N 20th Dr, Ste 12, Phoenix, AZ 85085-0621 | 2007-01-31 |
| 1154489136 | Mark D Boesen | Pharmacist | 23620 N 20th Dr, Ste 12, Phoenix, AZ 85085-0621 | 2006-12-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1235748369 | Nicole Fountain | Speech-Language Pathologist | 25700 N. 21st Avenue, Phoenix, AZ 85085 | 2020-07-24 |
| 1083138010 | Larry Leforte II | Emergency Medical Technician, Paramedic | 2018 W Blaylock Dr, Phoenix, AZ 85085 | 2017-08-01 |
| 1508318809 | Jennifer Falk | Chiropractor | 1614 W Whispering Wind Dr Ste 3, Phoenix, AZ 85085 | 2016-11-03 |
| 1053785964 | Cvs Pharmacy | Pharmacy | 28635 N North Vally Parkway, Phoenix, AZ 85085 | 2015-11-17 |
| 1417329897 | Kelly Criswell | Registered Nurse | 32150 N North Foothills Dr, Phoenix, AZ 85085 | 2015-10-26 |
| 1417333717 | Kristi Everett | Social Worker | 34225 N 27th Dr Bldg 5 Ste 146, Phoenix, AZ 85085 | 2015-08-10 |
| 1063849834 | Albertsons Pharmacy | Pharmacist | 2406 W Bramble Berry Ln, Phoenix, AZ 85085 | 2013-10-10 |
| 1427354851 | Carolyn Berg Newsome | Marriage & Family Therapist | 2060 W.whispering Wind Drive, Phoenix, AZ 85085 | 2011-02-02 |
| 1518273127 | Jamie Lynn Born | Social Worker | 34406 N 27th Dr Bldg 6, Phoenix, AZ 85085 | 2010-08-20 |
| 1023347218 | Lise Flores-reed | Psychologist | 34225 N. 27th Drive #110, Phoenix, AZ 85085 | 2009-12-17 |
| Find all providers in zip 85085 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386243848 | Stephen Praissman | Pharmacist | 3101 E Claremont Ave, Phoenix, AZ 85016-2361 | 2020-10-25 |
| 1356949929 | Teresa Louise Cox | Pharmacist | 1800 E Van Buren St., St. Luke's Behavioral Health, Phoenix, AZ 85006 | 2020-10-15 |
| 1760097703 | Cindy Ryanto | Pharmacist | 39508 W Daisy Mountain Dr, Phoenix, AZ 85086 | 2020-09-15 |
| 1689288037 | Akeel Daher | Pharmacist | 28635 N N Vly Pkwy, Phoenix, AZ 85085-5434 | 2020-09-03 |
| 1295346401 | Ann Michelle Mason | Pharmacist | 1511 E Renee Dr, Phoenix, AZ 85024-2973 | 2020-08-11 |
| 1053921767 | Vera Benson | Pharmacist | 1219 E Villa Maria Dr, Phoenix, AZ 85022-1222 | 2020-08-06 |
| 1154947133 | Justin Gerard Spicer | Pharmacist | 1 E Lexington Ave, Phoenix, AZ 85012-2433 | 2020-06-24 |
| 1518582501 | Davita D Lewis | Pharmacist | 2532 W Peoria Ave, Phoenix, AZ 85029-4709 | 2020-06-15 |
| 1518582683 | Thomas Komlos | Pharmacist | 18224 N Clemmer Ln, Phoenix, AZ 85022-1306 | 2020-06-14 |
| 1063037554 | Chezka Mae Largosa Baker | Pharmacist | 800 N Central Ave Apt 1218, Phoenix, AZ 85004-2777 | 2020-06-10 |
| Find all providers in PHOENIX | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.